NPIMap

Organization Active NPI

Natchitoches Parish Hospital Service District

  • Medicare Defined Swing Bed Hospital Unit
  • Natchitoches, LA
National Provider Identifier
1073647384
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
208 Issued in LA
Legal business name
NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT
Practice address
501 Keyser Ave
Natchitoches, LA 71457-6018
Phone
(318) 214-4200
Fax
(318) 214-4493
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. William B McCormick
Title
Cfo
Phone
(318) 214-4350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 208 LA Primary

Addresses

Primary practice location

501 Keyser Ave
Natchitoches, LA 71457-6018

Mailing address

PO Box 2009
Natchitoches, LA 71457-2009
Phone (318) 214-4200

Other names 1

  • NATCHITOCHES REGIONAL MEDICAL CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081125000231 LA Part A Provider - Hospital 2163322140 Practice locations: Natchitoches, LA

Hospital certification: CCN 19U007

Legal name
NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT
Doing business as
NATCHITOCHES REGIONAL MEDICAL CENTER
Organization structure
OtherNon-profit
Enrollment address
501 Keyser Ave
Natchitoches Regional Medical Center
Natchitoches, LA 71457-6018
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Natchitoches Parish Hosp15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ronald Corkern Individual Corporate DirectorBoard Member Aug 1, 2021
John Luster Individual Corporate DirectorBoard Member Aug 1, 2021
Michael Newton Individual Corporate DirectorBoard Chair Aug 1, 2021
Brent Probasco Individual Corporate OfficerCeo Jul 5, 2023
W-2 Managing EmployeeCeo Jul 5, 2023
Damian Kirk Soileau Individual Corporate OfficerCeo May 1, 2013 75%
Valencia Jones Individual Corporate DirectorBoard Member May 15, 2022
Wayne Halm Individual Corporate DirectorBoard Member Mar 27, 2024
Christopher L Ingram Individual Corporate DirectorBoard Member Aug 1, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Louisiana Extended Care Hospital of NatchitochesNatchitoches, LA, CCN 192035 Hospital 5% Or Greater Direct Ownership Interest (51%) Feb 24, 2024
Louisiana Extended Care Hospital of NatchitochesNatchitoches, LA, CCN 19TA35 Hospital 5% Or Greater Direct Ownership Interest (51%) Feb 24, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • LLC-I, LLC
    • Long Term Care Hospital
    • Natchitoches, LA
    • NPI 1083715841

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • LLC-I, LLC
    • Rehabilitation Hospital Unit
    • Natchitoches, LA
    • NPI 1417609975

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593129600000",
    "number": "1073647384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2009",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714572009",
            "telephone_number": "318-214-4200",
            "fax_number": "318-214-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 KEYSER AVE",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714576018",
            "telephone_number": "318-214-4200",
            "fax_number": "318-214-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "318-214-4350",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "LA",
            "license": "208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NATCHITOCHES REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NATCHITOCHES REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Natchitoches, LA

Sources for this page

Verify at the official NPI Registry.